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Series 707.7.4P - Request to Ride an Existing Magnet School Bus

 

This form should be completed by intradistrict and interdistrict transfer students that do not qualify for magnet school transportation but are able to use an existing magnet school bus.

Date of application                                        Transportation start date                    

student name (last, first, middle initial)         birth date                                                                                        _____      _____     _____

                                                                                                   

sex

M            F

 

parent/guardian name (last, first, middle initial)

telephone number

 

 

parent/guardian address (residence)

 

 

city

zip code

 

student address (if different from parent/guardian)

city

zip code

 

 

resident district of student

city

resident district number

 

previous school attended

 

grade attended

 

 

requested District 196 magnet school

 

grade attending

 

 

student will use bus:

to school only ❏          from school only ❏                   both  ❏

existing bus stop location (specify address of stop at which you wish student to be picked up and dropped off)

 

       

 

As a parent/guardian, I agree to provide for my child's safety while going to and from the District 196 bus stop prior to boarding and after disembarking from the bus.

A new form must be filled out prior to each school year. Requests will be approved after August 1.

 

_______________________________________                   ___________________________

signature of parent/guardian                                                          date

                                        

OFFICE USE ONLY

date received:

magnet student:     

new ❏      existing ❏

student ID:

date sent to transportation:

last school attended:

requested start date:

notes:

 

 

 

 

 

Return to:
Independent School District 196

Magnet School Specialist

3455 153rd Street West

Rosemount, MN  55068

Procedures/707.7.4P/1-19-10